Douglas Ingram
Analyst · Cowen. Your question, please
Thank you, Ian. Good afternoon and thank you all for joining Sarepta Therapeutics fourth quarter 2019 conference call. In 2018, we defined our vision to become one of the world's leaders in precision genetic medicine to treat rare disease, founded both on our precise and efficient RNA platform and on the build of a gene therapy engine capable of rapidly advancing multiple constructs through development into the patient community. In 2019, we executed, further matured, and brought that vision into greater focus, and in 2020 – through 2020, we will, if successful, realize much of that vision. We have an enormous number of milestones in 2020, but before we discuss them, let us review the progress that we have made in 2019. I will begin with our RNA platform As we announced at the JP Morgan conference in January, our fourth quarter 2019 revenue stands at $100 million. In our third full year since launch, our 2019 revenue was $381 million, a 26% increase over prior year. I will remind you that we have never taken a price increase since launch. So, our growth comes from continuing to serve the Duchenne community. Our 2020 guidance for EXONDYS is $420 million to $430 million. As we are just launching VYONDYS, we will wait until later this year before providing revenue guidance. But you can expect the launch curve similar to that of VYONDYS. In the third quarter, we obtained FDA approval for our second RNA therapy, VYONDYS 53. The approval of VYONDYS was a win for objective, evidence-based decision making. It was a win for hard working professionals at the FDA neurology division that was responsible for this review. And most importantly, it was a win for Exon 53 amenable patients. With the regulatory pathway we confirmed, we submitted our rolling NDA for casimersen, having announced positive results earlier in 2019. Assuming casimersen is approved, we will have three therapies capable of treating approximately 30% of the Duchenne community in the United States. We will have doubled the number of patients who may benefit from our PMO technology versus EXONDYS alone and we will be among an exceedingly small number of biotechnology companies who have internally discovered, developed and brought to the patient community three or more medicines. In 2019, we commenced our multi-ascending dose study for our next generation PMO technology, the peptide-conjugated PMO, or PPMO for short. Now, let's move on to our gene therapy engine. There we've made great progress in 2019 as well. Starting with SRP-9001, our gene therapy for the treatment of Duchenne muscular dystrophy, using our micro-dystrophin construct. We have completed all dosing in what became a 41-patient placebo-controlled trial, Study 102. Patients are now crossing over at the end of their 48-week period. By now, between our first proof of concept study, our main study for 102, and our crossover, we have dosed more than 30 Duchenne boys with active gene therapy. The study continues uninterrupted and the last patient, last visit should occur in December of this year. We have designed our next placebo-controlled trial using our commercial process material, and we've taken initial feedback from the agency. This trial, which we call Study 301, is designed as a global placebo-controlled multicenter trial. We have made significant progress on manufacturing. With our partners, Thermo Fisher and Catalent, we have built significant capacity with a dedicated facility completed in Lexington, Massachusetts, and even greater capacity than that built at Catalent. Our hybrid manufacturing approach is taking shape with AAV/PV expertise at our Columbus site and a dedicated AAV/PV site in Burlington, Massachusetts. This intellectual hub has been responsible for some of our most meaningful advances in 2019. Consider that we have now achieved at scale commercially viable yields for SRP-9001. We announced at JP Morgan that we had commenced engineering runs. By now, I can tell you that we have commenced our GMP runs for SRP-9001. And we're making great progress on assay development as well. We've made great progress on our limb-girdle pipeline in 2019. To remind you, LGMD or limb girdle muscular dystrophy is an umbrella name for a collection of serious, often fatal, neuromuscular diseases. None of these diseases have available therapies. So, the opportunity to bring a better life for these patients is compelling. In the first quarter of 2019, we exercised our option and acquired Myonexus, gaining access to its five LGMD programs. And then, we later entered into a licensed option with NCH to gain access to Dr. Zarife Sahenk's LGMD candidate for LGMD2A. These six programs together have the potential of providing treatments for over 70% of patients with LGMD. In the first quarter of 2019, we presented expression and safety data from our first three-patient proof of concept cohort for LGMD2E and it was impressive. Expression was 50% on IHC and 37% of normal on Western blot. We came back in the fourth quarter and we updated with nine-month functional data, indicating that every child was improving on every functional endpoint. We can mention one additional higher-dose three-patient cohort in 2019 at a four times higher dose with the goal of making a dose selection in 2020 this year. Moving on to the rest of our gene therapy engine, 2019 was equally consequential. With our partner, Lysogene, we commenced a gene therapy trial for MPS III A or Sanfilippo syndrome type A, a devastating neurological lysosomal storage disease. We built out our gene therapy Center of Excellence in Columbus, Ohio. Our center of excellence is already building new constructs and advancing the science of gene therapy. We entered into 14 transactions in 2019 and we in-licensed or purchased 18 new constructs, bringing the total number of research and development programs to 42 across our two platforms. And we've employed a clever incubation strategy that allows us to build an enormously large pipeline, while still permitting us to remain razor focused on our near-term objectives and milestones. And, of course, we entered into a transformational alliance with Roche in the fourth quarter of 2019 where Roche will take SRP-9001 to patients outside the United States. This alliance, by far the largest ex-US single candidate license in biopharmaceutical history, validates our approach, our progress and the value of our program. But it also serves our mission. If SRP-9001 proves successful, Roche with its very impressive ex-US resources and international expertise, will bring our therapy to far more patients far faster than we could have ever done on our own. And it places us in an enviable position with the resources to drive our vision and to execute our plans. With the close of our alliance this quarter, we have well over $2 billion of cash on our balance sheet today. Add to that, the fact that we have just entered into an agreement to sell our VYONDYS priority review voucher for $111 million. Add again to that our revenue this year for EXONDYS and VYONDYS and it should become clear that we are well positioned with the resources, the assets and the talent to drive our ambitious strategy to fruition. Looking forward, you will see that 2020 is dense with milestones. So, starting with our gene therapy portfolio for 2020. With respect to SRP-9001, we will continue to execute Study 102 with our 48-week last patient, last visit in December of this year. We will unblind, evaluate and release those results, which should occur in the first quarter of 2021. We are preparing to commence our commercial supply trial, Study 301. Broadly, we have three work streams for Study 301. We must complete site initiation and training. We must complete our assay work, our engineering work and our GMP runs. And if all goes well, we should have GMP material released this July. We need to work with the division to obtain their concurrence on the commencement of Study 301. So, of course, there's a lot to do here, but the team is making exceptional progress today. With respect to our LGMD pipeline, we have dosed all three patients now in our high dose cohort for LGMD2E. We will have expression and safety results available in the second quarter and we anticipate announcing that data at an appropriate medical meeting in the second quarter. We will make a formal dose selection decision in the third quarter. We will completely assay and process development work for LGMD2E, with the goal of having GMP material available in time to commence a trial in early 2021. We will also begin the AAV/PV work for other of our LGMD constructs as well. We will continue our dialogue with the FDA and come to a view on the development and regulatory pathway for LGMD2E and then the remainder of the LGMD pipeline. Our goal is to have all of that completed by year-end, so we could commence a trial with commercial process material early next year. We've also dosed 17 patients on our MPS III A gene therapy program and intend to complete all the dosing by the middle of the year. Our collaborator on CMT, otherwise known as Charcot-Marie-Tooth, Dr. Zarife Sahenk at Nationwide Children's Hospital, had intended to commence a proof of concept study for CMT last year, but did not have NCH release the material enabling her to do that. That material should be available this year. And Dr. Sahenk intends to commence that study in 2020 in addition to our gene therapy center of excellence in Columbus, Ohio, we are also building a separate gene editing innovation center under the guidance of Dr. Charlie Gersbach of Duke University in Durham, North Carolina and should have that largely complete this year. We have also significant milestones for our RNA platform this year. We should complete our rolling submission for casimersen in the second quarter of 2020. We plan to release the results from our PROMOVI study at the NDA Scientific Conference in March. These results from patients that met the enrollment criteria for 201/202 – that's the study which formed the basis for the eteplirsen approval, are consistent with the 212/202 data set. And we will have dosing and safety insight on our next generation RNA platform, the PPMO this year as well. If PPMO is successful, it could be a significant advancement in our RNA technology and platform. In summary, we have an enormous amount of work to do this year, but that work will be profoundly consequential for Sarepta and, of course, more importantly for the patients that we serve. To those who may say our plans are ambitious, I would agree, but they are not driven by hubris. They are informed instead by an abiding conviction, founded on objective evidence that the science of genetic medicine has come of age, that a revolution of healthcare is upon us now and that Sarepta is playing a leading role in translating that science to practical therapies that improve countless lives, otherwise stolen by serious rare genetic disease. And it is in that spirit that I would invite you to join Sarepta and rare disease patients in the US and around the world in recognizing Rare Disease Day this Saturday, February 29, as we continue to bring awareness about rare diseases and the work that remains to bring therapies to patients fighting those diseases every day. And with that, I will turn the call over to Sandy to provide an update on the financials. Sandy?